Resolving insurance claims with Artificial Intelligence powered decision making

Balaji Dhashanamoorthi *

Master of Engineering, Control and Instrumentation, CEG, Anna University, Chennai, India.
 
Review
International Journal of Science and Research Archive, 2023, 10(02), 255–271.
Article DOI: 10.30574/ijsra.2023.10.2.0946
Publication history: 
Received on 03 October 2023; revised on 16 November 2023; accepted on 19 November 2023
 
Abstract: 
This study explores how Artificial Intelligence (AI) can improve the speed and efficiency of dispute resolution in road traffic accident (RTA) insurance claims, which can benefit the society and the economy. We propose and apply a systematic AI-based method to estimate the costs and guide the negotiation process, instead of relying on official guidelines and lawyer expertise. We use 88 real-life RTA cases and find a strong correlation between the final judicial cost and the length of the most severe injury, with a high predicted R2 value of 0.527. We also demonstrate how various AI tools can help with information extraction and outcome prediction:
·         How regular expression (regex) can obtain accurate injury data for further analysis;
·         How different natural language processing (NLP) techniques can make predictions directly from text.
Our RegEx framework can automatically extract information from different report formats; different NLP methods can produce similar reasonable results. This research shows how AI can be used for social good to transform legal-related decision-making processes, support legal actions, and optimize legal resource use.
 
Keywords: 
Professional service operation; Insurance claim; Civil litigation; AI; Natural language processing
 
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Copyright © 2023 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0